710 results on '"Pompucci A."'
Search Results
152. Macrophages and lymphocytes differentially modulate the ability of RANTES to inhibit HIV-1 infection
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Barbara Sherry, Giovanni Franchin, Lorena Pompucci, Helena Schmidtmayerova, C A Amella, and Eleanore Gross
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Chemokine ,Anti-HIV Agents ,media_common.quotation_subject ,Immunology ,HIV Infections ,Endogeny ,Biology ,Virus Replication ,Polymerase Chain Reaction ,Virus ,Receptors, HIV ,Reference Values ,Viral entry ,Humans ,Immunology and Allergy ,Lymphocytes ,Receptor ,Internalization ,Chemokine CCL5 ,Cells, Cultured ,media_common ,Acquired Immunodeficiency Syndrome ,Macrophages ,Biological Transport ,Cell Biology ,Virology ,Viral replication ,HIV-1 ,biology.protein ,Zidovudine ,Intracellular - Abstract
The β-chemokines MIP-1α, MIP-1β, and RANTES inhibit HIV-1 infection of CD4+ T cells by inhibiting interactions between the virus and CCR5 receptors. However, while β-chemokine-mediated inhibition of HIV-1 infection of primary lymphocytes is well documented, conflicting results have been obtained using primary macrophages as the virus target. Here, we show that the β-chemokine RANTES inhibits virus entry into both cellular targets of the virus, lymphocytes and macrophages. However, while virus entry is inhibited at the moment of infection in both cell types, the amount of virus progeny is lowered only in lymphocytes. In macrophages, early-entry restriction is lost during long-term cultivation, and the amount of virus produced by RANTES-treated macrophages is similar to the untreated cultures, suggesting an enhanced virus replication. We further show that at least two distinct cellular responses to RANTES treatment in primary lymphocytes and macrophages contribute to this phenomenon. In lymphocytes, exposure to RANTES significantly increases the pool of inhibitory β-chemokines through intracellular signals that result in increased production of MIP-1α and MIP-1β, thereby amplifying the antiviral effects of RANTES. In macrophages this amplification step does not occur. In fact, RANTES added to the macrophages is efficiently cleared from the culture, without inducing synthesis of β-chemokines. Our results demonstrate dichotomous effects of RANTES on HIV-1 entry at the moment of infection, and on production and spread of virus progeny in primary macrophages. Since macrophages serve as a reservoir of HIV-1, this may contribute to the failure of endogenous chemokines to successfully eradicate the virus.
- Published
- 2003
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153. L'eredità intellettuale di Paolo Mascagni
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Agliano', Margherita, Barni, Mauro, Benocci, Andrea, Bracci, Rodolfo, Bratto, Chiara, Burgassi, Pierdomenico, Colao, Floriana, Donati, Donato, Ferri, Sara, Manganelli, Giuseppe, Martelli, Paola, Millucci, Vincenzo, Orsini, Davide, Pagli, Paolo, Pompucci, Giuseppe, Vannozzi, Francesca, and Vergari, Daniele
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Anatomia ,Paolo Mascagni, Anatomia, Storia della medicina ,Storia della medicina ,Paolo Mascagni - Published
- 2015
154. Fatal inflammatory AIDS-associated PML with high CD4 counts on HAART: a new clinical entity?
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Di Giambenedetto, Simona, Vago, G, Pompucci, Angelo, Scoppetuolo, G, Cingolani, Antonella, Marzocchetti, A, Tumbarello, Mario, Cauda, Roberto, De Luca, Andrea, Di Giambenedetto, Simona (ORCID:0000-0001-6990-5076), Pompucci, Angelo (ORCID:0000-0002-5427-9719), Cingolani, Antonella (ORCID:0000-0002-3793-2755), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Cauda, Roberto (ORCID:0000-0002-1498-4229), De Luca, Andrea (ORCID:0000-0002-8311-6935), Di Giambenedetto, Simona, Vago, G, Pompucci, Angelo, Scoppetuolo, G, Cingolani, Antonella, Marzocchetti, A, Tumbarello, Mario, Cauda, Roberto, De Luca, Andrea, Di Giambenedetto, Simona (ORCID:0000-0001-6990-5076), Pompucci, Angelo (ORCID:0000-0002-5427-9719), Cingolani, Antonella (ORCID:0000-0002-3793-2755), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Cauda, Roberto (ORCID:0000-0002-1498-4229), and De Luca, Andrea (ORCID:0000-0002-8311-6935)
- Abstract
No abstract available
- Published
- 2004
155. Combined treatment of advanced stages of recurrent skin cancer of the head
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Pompucci, Angelo, Rea, Giancarla, Farallo, Eugenio Giuseppe, Salgarello, Marzia, Campanella, A, Fernandez Marquez, Eduardo Marcos, Pompucci, Angelo (ORCID:0000-0002-5427-9719), Salgarello, Marzia (ORCID:0000-0003-4296-4214), Fernandez Marquez, Eduardo Marcos (ORCID:0000-0001-5535-1412), Pompucci, Angelo, Rea, Giancarla, Farallo, Eugenio Giuseppe, Salgarello, Marzia, Campanella, A, Fernandez Marquez, Eduardo Marcos, Pompucci, Angelo (ORCID:0000-0002-5427-9719), Salgarello, Marzia (ORCID:0000-0003-4296-4214), and Fernandez Marquez, Eduardo Marcos (ORCID:0000-0001-5535-1412)
- Abstract
The authors investigated whether skull base resection and primary free-flap reconstruction in a single-stage surgery is oncologically effective for treating advanced stages of recurrent skin cancer (RSC) of the head.
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- 2004
156. Acute Management of Head Injury
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Maurizio Iacoangeli, Romeo Roselli, Angelo Pompucci, and Massimo Scerrati
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General Earth and Planetary Sciences ,General Environmental Science - Published
- 2000
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157. Metabolic fate of extracellular NAD in human skin fibroblasts
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G. Pompucci, Maria Francesca Aleo, Augusto Preti, M. L. Giudici, Silvia Sestini, and Paola Danesi
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Purine ,Biology ,Biochemistry ,chemistry.chemical_compound ,Nucleotidase ,medicine ,Inosine ,NAD-glycohidrolase ,Molecular Biology ,Hypoxanthine ,Nicotinamide mononucleotide ,purine ,Adenosine transport ,ectoenzymes ,Cell Biology ,NAD ,adenosine ,uptake ,human skin fibroblasts ,Molecular biology ,Adenosine ,chemistry ,NAD+ kinase ,medicine.drug - Abstract
Extracellular NAD is degraded to pyridine and purine metabolites by different types of surface-located enzymes which are expressed differently on the plasmamembrane of various human cells and tissues. In a previous report, we demonstrated that NAD-glycohydrolase, nucleotide pyrophosphatase and 5'-nucleotidase are located on the outer surface of human skin fibroblasts. Nucleotide pyrophosphatase cleaves NAD to nicotinamide mononucleotide and AMP, and 5'-nucleotidase hydrolyses AMP to adenosine. Cells incubated with NAD, produce nicotinamide, nicotinamide mononucleotide, hypoxanthine and adenine. The absence of ADPribose and adenosine in the extracellular compartment could be due to further catabolism and/or uptake of these products. To clarify the fate of the purine moiety of exogenous NAD, we investigated uptake of the products of NAD hydrolysis using U-[(14)C]-adenine-NAD. ATP was found to be the main labeled intracellular product of exogenous NAD catabolism; ADP, AMP, inosine and adenosine were also detected but in small quantities. Addition of ADPribose or adenosine to the incubation medium decreased uptake of radioactive purine, which, on the contrary, was unaffected by addition of inosine. ADPribose strongly inhibited the activity of ecto-NAD-hydrolyzing enzymes, whereas adenosine did not. Radioactive uptake by purine drastically dropped in fibroblasts incubated with (14)C-NAD and dipyridamole, an inhibitor of adenosine transport. Partial inhibition of [(14)C]-NAD uptake observed in fibroblasts depleted of ATP showed that the transport system requires ATP to some extent. All these findings suggest that adenosine is the purine form taken up by cells, and this hypothesis was confirmed incubating cultured fibroblasts with (14)C-adenosine and analyzing nucleoside uptake and intracellular metabolism under different experimental conditions. Fibroblasts incubated with [(14)C]-adenosine yield the same radioactive products as with [(14)C]-NAD; the absence of inhibition of [(14)C]-adenosine uptake by ADPribose in the presence of alpha-beta methyleneADP, an inhibitor of 5' nucleotidase, demonstrates that ADPribose coming from NAD via NAD-glycohydrolase is finally catabolised to adenosine. These results confirm that adenosine is the NAD hydrolysis product incorporated by cells and further metabolized to ATP, and that adenosine transport is partially ATP dependent.
- Published
- 2000
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158. Open-door laminoplasty for cervical stenotic myelopathy: surgical technique and neurophysiological monitoring
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Domenico Restuccia, Massimiliano Valeriani, Francesco Formica, Massimo Scerrati, R. Roselli, Angelo Pompucci, and Vincenzo Di Lazzaro
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Constriction, Pathologic ,Electromyography ,Central nervous system disease ,Evoked Potentials, Somatosensory ,Bone plate ,medicine ,Humans ,Orthopedic Procedures ,Evoked potential ,Aged ,Monitoring, Physiologic ,Titanium ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Syndrome ,General Medicine ,Middle Aged ,Evoked Potentials, Motor ,medicine.disease ,Laminoplasty ,Magnetic Resonance Imaging ,Surgery ,Stenosis ,medicine.anatomical_structure ,Cervical Vertebrae ,Female ,Tomography, X-Ray Computed ,business ,Bone Plates ,Cervical vertebrae - Abstract
Object. A modified technique of open-door laminoplasty for cervical stenotic myelopathy (CSM) is described, and the role of evoked potential monitoring in selecting patients for surgery and evaluating results is discussed. Methods. Between October 1992 and October 1996, 33 patients with CSM underwent open-door laminoplasty. After surgery, in 27 patients (81.8%) different levels of clinical improvement were demonstrated, and in five of them (15%) full recovery was observed. The Japanese Orthopaedic Association score increased from 5 to 12 (mean 9.8) preoperatively to 8 to 14 (mean 11.6) postoperatively. At 1-year follow up, the N13 cervical response was restored in nine (75%) of 12 patients with isolated presurgical abnormality and in 57.1% of those with combined abnormalities of both N13 and P14 response. Although significant clinical improvement was observed in 82% of the cases, in 24 of 33 patients MEP abnormalities persisted at least at one explored level. Conclusions. Of several laminoplasty techniques, the one described here offers some advantages: preservation of biomechanical function of posterior muscular—ligamentous complex, prevention of laminar collapse, smaller degrees in reduction of range of cervical motion, stabilization of the spine with no postoperative malalignment, and maintenance of decompressive effect that avoids recurrent stenosis. Neurophysiological studies sometimes clarified neurological disorders that were only suspected on the basis of history and/or clinical examination, leading to early diagnosis.
- Published
- 2000
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159. Preface
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Giacomello, Alessandro, Peters, G. J., Eriksson, Staffan, De Abreu, Ronney, Kristensen, T., Munch-Petersen, B., Vincenzetti, S., Cambi, A., Neuhard, J., Garattini, E., Vita, A., Oka, J., Matsumoto, A., Hosokawa, Y., Inoue, S., Allegrini, S., Johnson, R. B., Fiol, C. J., Eriksson, S., Fabianowska-Majewska, K., Wasiak, T., Duley, J., Simmonds, A., Bretner, M., Felczak, K., Poznański, J., Dzik, J. M., Golos, B., Jarmuła, A., Rode, W., Kulikowski, T., Codacci-Pisanelli, G., Pinedo, H. M., Noordhuis, P., van Groeningen, C. J., van der Wilt, C. L., Franchi, F., Hatse, S., Balzarini, J., De Clercq, E., Marinello, E., Rosi, F., Dispensa, E., Mangiavacchi, P., Riario-Sforza, G., Agostinho, A. B., Smolenski, R. T., Müller, Mathias M., Roch-Ramel, F., Guisan, B., Diezi, J., Tavenier, M., Skladanowski, A. C., de Abreu, R. A., de Jong, J. W., Åmellem, Øystein, Löffler, Monika, Pettersen, Erik O., Boulieu, R., Lenoir, A., Bertocchi, M., Mornex, J. F., Makarewicz, W., Spychala J., Mitchell B. S., Barankiewcz J., Góra-Tybor, Joanna, Robak, Tadeusz, Spasokukotskaja T., Sasvári-Székely M., Piróth Zs., Kazimierczuk Z., Staub M., Keuzenkamp-Jansen, C W, De Abreu, R A, Bökkerink, J P M, Trijbels, J M F, Eriksson S., Warzocha, K., Krykowski, E., Góra-Tybor, J., Fronczak, A., Robak, T., Minelli, A., Moroni, M., Monacelli, N., Mezzasoma, I., Amici, A., Emanuelli, M., Raffaelli, N., Ruggieri, S., Magni, G., Carta, M. C., Mattana, A., Poddie, F., Sgarrella, F., Tozzi, M. G., Veerman, G., Ruiz van Haperen, V. W. T., van Moorsel, C. J. A., Pesi, R., Baiocchi, C., Camici, M., Ipata, P. L., Kozłowska, M., Świerczyński, J., Smoleński, R. T., Jastorff, B., Messina, E., Savini, F., Procopio, A., Giacomello, A., Wielgus-Kutrowska, B., Kulikowska, E., Wierzchowski, J., Bzowska, A., Shugar, D., Fairbanks, Lynette D, Ruckemann, Katarzyna, Simmonds, H Anne, Kaletha, K., Szymańska, G., Thebault, M., Raffin, J. P., Le Gal, Y., Griesmacher, Andrea, De Abreu, Ronney A., Zych, M., Ruckemann, K., Jagodzinski, P., Kochan, Z., Stolk, J., Boerbooms, A., De Abreu, R., de Koning, D., van de Putte, L., Fiorini, M., Bazzichi, L., Bertolini, G., Martini, C., Ciompi, M. L., Lucacchini, A., Pizzichini, M., Terzuoli, L., Arezzini, L., Fe, L., Pagani, R., Miscetti, P., Allegrucci, C., Sebesta, I., Duley, J. A., Simmonds, H. A., Gross, M., Salerno, C., Stone, T. W., Van den Berghe, G., Valik, Dalibor, Jones, James D., Guerranti, R., Fè, L., Sforza, G. Riario, Knecht, Wolfgang, Grein, Klaus, Lodi, R., Iotti, S., Barbiroli, B., Bonin, B., Chantin, C., Bory, C., Micheli, V., Jacomelli, G., Morozzi, G., Fioravanti, A., Marcolongo, R., Pompucci, G., Peters G J, Noordhuis P, Komissarov A, Holwerda U, Kok R M, Van Laar J A M, Van der Wilt C L, Van Groeningen C J, Pinedo H M, Perrett, David, Jacobsson, Bengt, Sisto A., Iezzi A., Di Carlo M., Pizzigallo E., Akhondzadeh, S., MacGregor, D. G., Ogilvy, H. V., Zoref-Shani, E., Brosh, S., Sidi, Y., Bromberg, Y., Sperling, O., van Gennip, A. H., Abeling, N. G. G. M., Stroomer, A. E. M., van Lenthe, H., Bakker, H. D., van Kuilenburg, A. B. P., Connolly, G. P., Abbott, N. J., Lilling, G., Gozes, I., Vreken, P., Meinsma, R., de Ahreu, R. A., Diasio, R. B., Albin, N., Johnson, M. R., Shahinian, H., Wang, K., Gathof, B. S., Rocchigiani, M., Puig, J. G., Mateos, F., Sestini, S., Krijt, J., Shin, Y., Gresser, U., Costa, A., Maximova, N., Andolina, M., Paci, M., Carrozzi, M., Osbich, A., Durighello, M., Cavalli, F., Geatti, O., Zammarchi, E., Morgan, Gareth, Webster, A. D. B., Slavin, S., Naparstek, E., Nagler, A., Acker, M., Cividalli, G., Kapellushnik, Y., Varadi, G., Ben-Yoseph, R., Or, R., Parfenov, V. V., Ignatenko, M. A., Amchenkova, A. M., Narovlyansky, A. N., Spoto, G., Mastropasqua, L., Gizzi, F., Arduini, A., Del Gallo, P., Ciancaglini, M., Gallenga, P. E., Šebesta, I., Zeman, J., Crifò, C., Di Vito, M., Lomonte, A., Gerber, G., Carlucci, F., Tabucchi, A., Vannoni P., Di Pietro M. C., Vincent, M. F., Bontemps, F., Boer, P., Rötzer, E., Ehrmann, D., Empl, W., Bride, M. B. Mc, Ogg, C. S., Cameron, J. S., Moro, F., Rigden, S., Rees, L., Hoff, W. Van't, Raman, V., Palmieri, P., Mastropierro, G., Albertazzi, A., Rucci, C., Darlington, L. G., Cotton, S. R., de Gorter, J. J., Lawrence, E. S., Petrie, A., Sarsam, R. P., Semple, M. J., Warburton, E. A., Quaratino, C. P., Talone, L., Di Sciascio, N., Hrebíček, M. H., Poupětová, H., Ledvinová, J., Elleder, M., Vondrák, K., Rees, P. C., Wonke, B., Thein, S. L., Clegg, J. B., Marlewski, M., Pennelli, A., Di Marzio, M., Angelini, G., Sabatino, G., de Koning, P., Kerstens, P., de Graaf, R., Hayek, G., and Cardona, F.
- Published
- 1995
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160. Hypoxanthine-guanine phosphoribosyltransferase deficiency and erythrocyte synthesis of pyridine coenzymes
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Gabriella Jacomelli, S. Sestini, Vanna Micheli, E. Zammarchi, F. Manzoni, Birgit S. Gathof, L. Peruzzi, G. Pompucci, and Marina Rocchigiani
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Adult ,Male ,Purine ,Hypoxanthine Phosphoribosyltransferase ,Erythrocytes ,Adolescent ,Lesch-Nyhan Syndrome ,Pyridines ,Nicotinamide adenine dinucleotide ,General Biochemistry, Genetics and Molecular Biology ,chemistry.chemical_compound ,Amide Synthases ,medicine ,Humans ,Pentosyltransferases ,General Pharmacology, Toxicology and Pharmaceutics ,Child ,Purine metabolism ,Purine Nucleotides ,chemistry.chemical_classification ,biology ,Nicotinic Acids ,Tryptophan ,Infant ,General Medicine ,Middle Aged ,NAD ,medicine.disease ,Kinetics ,Enzyme ,Biochemistry ,chemistry ,Purines ,Hypoxanthine-guanine phosphoribosyltransferase ,Child, Preschool ,biology.protein ,Phosphoribosyltransferase ,Female ,Pyrimidine Nucleotides ,NAD+ kinase ,Lesch–Nyhan syndrome - Abstract
Purine and pyridine metabolism were studied in ten Lesch-Nyhan patients, with virtually no hypoxanthine-guanine phosphoribosyltransferase (HPRT) activity in erythrocytes. Increased NAD erythrocyte concentrations were found in all patients. Raised activities of two enzymes catalysing NAD synthesis from nicotinic acid (nicotinic acid phosphoribosyltransferase: NAPRT, and NAD synthetase: NADs) was found in erythrocyte lysates from all patients. The two enzymes had normal apparent Km for their substrates and increased Vmax. The rate of synthesis of pyridine nucleotides from nicotinic acid by intact erythrocytes in vitro was also increased in most patients. These findings suggest that raised NAD concentrations in HPRT- erythrocytes are due to enhanced synthesis as a result of increased enzyme activities.
- Published
- 1999
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161. Cutaneous fistula is a rare presentation of Pott's puffy tumour
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A. Pompucci, P. Magistrelli, M. Castagneto, G. Paludetti, L. Corina, E. Minutilli, and C. Anile
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medicine.medical_specialty ,business.industry ,Cutaneous fistula ,Medicine ,Surgery ,Presentation (obstetrics) ,business ,Pott's puffy tumour - Published
- 2008
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162. The fate of a macroporous hydroxyapatite cranioplasty four years after implantation: Macroscopical and microscopical findings in a case of recurrent atypical meningioma
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Frassanito, Paolo, De Bonis, Pasquale, Mattogno, Pier Paolo, Mangiola, Annunziato, Novello, Mariangela, Brinchi, Domenico, Pompucci, Angelo, and Anile, Carmelo
- Published
- 2013
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163. Prevalence of mutations in LEP, LEPR, and MC4R genes in individuals with severe obesity
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Paolini, B, Maltese, Pe, Del Ciondolo, I, Tavian, Daniela, Missaglia, Sara, Ciuoli, C, Zuntini, M, Cecchin, S, Bertelli, M, Pompucci, G., Tavian, Daniela (ORCID:0000-0003-3333-0068), Missaglia, Sara (ORCID:0000-0001-6551-6698), Paolini, B, Maltese, Pe, Del Ciondolo, I, Tavian, Daniela, Missaglia, Sara, Ciuoli, C, Zuntini, M, Cecchin, S, Bertelli, M, Pompucci, G., Tavian, Daniela (ORCID:0000-0003-3333-0068), and Missaglia, Sara (ORCID:0000-0001-6551-6698)
- Abstract
Obesity is a major public health concern; despite evidence of high heritability, the genetic causes of obesity remain unclear. In this study, we assessed the presence of mutations in three genes involved in the hypothalamic leptin-melanocortin regulation pathway (leptin, LEP; leptin receptor, LEPR; and melanocortin-4 receptor, MC4R), which is important for energy homeostasis in the body, in a group of patients with severe obesity. For this study, we selected 77 patients who had undergone bariatric surgery and had a pre-operative body mass index (BMI) >35 kg/m2, early onset and a family history of being overweight. Candidate genes were screened by direct sequence analysis to search for rare genetic variations. The common LEP -2548 G/A polymorphism was also evaluated for its influence on the BMI (in obesity patients) and for obesity risk, using a case-control study involving 117 healthy individuals. Two different non-synonymous alterations in MC4R were found in two patients: the p.(Thr112Met), previously described in the literature as a probable gene involved in the obesity phenotype, and the novel p.(Tyr302Asp) variant, predicted to be pathogenic by in silico evaluations and family segregation studies. The LEP -2548 G/A polymorphism was not associated with the BMI or obesity risk. In conclusion, we have reported a novel mutation in MC4R in a family of Italian patients with severe obesity. Screening for MC4R could be important for directing the carriers of mutations towards therapy including partial agonists of the MC4R that could normalize their appetite and inhibit compulsive eating. Next-generation sequencing could be used to clarify the genetic basis of obesity in the future.
- Published
- 2016
164. An extremely rare case of a single isolated pituitary metastasis from hepatocellular carcinoma
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La Rocca, Giuseppe, primary, Mattogno, Pier P., additional, Pompucci, Angelo, additional, Coli, Antonella, additional, Rigante, Mario, additional, and Mangiola, Annunziato, additional
- Published
- 2016
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165. Spontaneous chronic subdural hematomas in young adults with a deficiency in coagulation factor XIII. Report of three cases
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A. Tuttolomondo, Angelo Pompucci, Giovanni Sabatino, Alessio Albanese, Annunziato Mangiola, Guiseppe Licata, Carmelo Anile, Antonio Pinto, ALBANESE A, TUTTOLOMONDO A, ANILE C, SABATINO G, POMPUCCI A, PINTO A, LICATA G, and MANGIOLA A
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Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Coagulation Factor Deficiency ,subdural hematorna ,Head trauma ,coagulopathy ,Pathogenesis ,Hematoma ,medicine ,Coagulopathy ,Humans ,Postoperative Care ,Vascular disease ,business.industry ,Headache ,factor XIII ,Factor XIII ,medicine.disease ,Factor XIII Deficiency ,Magnetic Resonance Imaging ,Surgery ,Coagulative necrosis ,Hematoma, Subdural, Chronic ,business ,medicine.drug - Abstract
✓ Chronic subdural hematomas (SDHs) generally occur in elderly patients. Its pathogenesis is usually related to head trauma with tearing and rupture of the bridging veins, although in some cases a history of trauma is not recognizable. There are many reports regarding the association between spontaneous chronic SDHs and an alteration in coagulative parameters. A coagulative disorder should be suspected when an unexplained hemorrhage occurs, especially in a young patient. The authors report on three young men with a deficiency in coagulation factor XIII (FXIII) who underwent surgery for chronic SDHs. The role of FXIII in the pathogenesis of chronic SDH is emphasized. In patients with unexplained chronic SDH all coagulation parameters and factors should be screened to identify an eventual coagulative disorder.
- Published
- 2005
166. Antiplatelet/Anticoagulant Agents and Chronic Subdural Hematoma in the Elderly
- Author
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Massimo Volpe, Angelo Pompucci, Annunziato Mangiola, Gianluca Trevisi, Pasquale De Bonis, Chiara De Waure, Carmelo Anile, and Antonella Sferrazza
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Genetics and Molecular Biology (all) ,Male ,Epidemiology ,Settore MED/27 - NEUROCHIRURGIA ,Medicine (all) ,Biochemistry, Genetics and Molecular Biology (all) ,Agricultural and Biological Sciences (all) ,Logistic regression ,Cardiovascular ,Biochemistry ,Clinical Epidemiology ,Chronic ,Geriatrics ,Hematoma ,Multidisciplinary ,Anticoagulant ,Hematology ,Platelet aggregation inhibitor ,Medicine ,Regression Analysis ,Anticoagulant Agent ,Female ,Research Article ,Platelets ,medicine.medical_specialty ,Drugs and Devices ,medicine.drug_class ,Science ,Neurosurgery ,Subdural ,Cardiovascular Pharmacology ,Aged ,Anticoagulants ,Case-Control Studies ,Hematoma, Subdural, Chronic ,Humans ,Platelet Aggregation Inhibitors ,NO ,Internal medicine ,medicine ,Coagulation Disorders ,business.industry ,Pharmacoepidemiology ,Case-control study ,Emergency department ,medicine.disease ,Surgery ,business - Abstract
Background and purposeIn the last decade there has been an increasing use of antiplatelet/anticoagulant agents in the elderly. The aim of the study was to evaluate the association between exposure to anticoagulant/antiplatelet therapy and chronic subdural haematoma-CSDH.MethodsSingle institution case-control study involving 138786 patients older than 60 years who visited our academic tertiary care Emergency Department from January 1st 2001 to December 31st 2010. 345 patients with CSDH (cases) were identified by review of ICD-9 codes 432.1 and 852.2x. Case and controls were matched with a 1:3 ratio for gender, age (± 5 years), year of admission and recent trauma. A conditional logistic model was built. A stratified analysis was performed with respect to the presence (842 patients) or absence (536 patients) of recent trauma.ResultsThere were 345 cases and 1035 controls. Both anticoagulant and antiplatelet agents were associated with an increased risk of CSDH with an OR of 2.46 (CI 95% 1.66-3.64) and 1.42 (CI 95% 1.07-1.89), respectively. OR was 2.70 (CI 95% 1.75-4.15), 1.90 (CI 95% 1.13-3.20), and 1.37(CI 95% 0.99-1.90) for patients receiving oral anticoagulants, ADP-antagonists, or Cox-inhibitors, respectively. History of recent trauma was an effect modifier of the association between anticoagulants and CSDH, with an OR 1.71 (CI 95% 0.99-2.96) for patients with history of trauma and 4.30 (CI 95% 2.23-8.32) for patients without history of trauma.ConclusionsAnticoagulant and antiplatelet therapy have a significant association with an increased risk of CSDH. This association, for patients under anticoagulant therapy, appears even stronger in those patients who develop a CSDH in the absence of a recent trauma.
- Published
- 2013
167. Factors of surgical outcome in tumoural epilepsy
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Rossi, Gf, Pompucci, Angelo, Colicchio, Gabriella, Scerrati, M., Pompucci, Angelo (ORCID:0000-0002-5427-9719), Rossi, Gf, Pompucci, Angelo, Colicchio, Gabriella, Scerrati, M., and Pompucci, Angelo (ORCID:0000-0002-5427-9719)
- Abstract
The purposes of the study were the assessment of the role of surgery in the suppression of epilepsy due to low-grade primitive cerebral tumours and the search for factors relevant to the surgical outcome.
- Published
- 1999
168. Prognostic factors in low grade (WHO grade II) gliomas of the cerebral hemispheres: the role of surgery
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Maurizio Iacoangeli, Angelo Pompucci, R. Roselli, Massimo Scerrati, and G F Rossi
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Adult ,medicine.medical_specialty ,Multivariate analysis ,Adolescent ,Medical Records ,Central nervous system disease ,Glioma ,medicine ,Humans ,Risk factor ,Survival rate ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Age Factors ,Brain ,Supratentorial Neoplasms ,Retrospective cohort study ,Magnetic resonance imaging ,Middle Aged ,Prognosis ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,Survival Rate ,Psychiatry and Mental health ,Treatment Outcome ,Cerebral hemisphere ,Neurology (clinical) ,Tomography, X-Ray Computed ,business ,Research Article - Abstract
OBJECTIVE: To assess the role of surgery on survival of patients with grade II gliomas of the cerebral hemispheres. METHODS: One hundred and thirty one low grade hemispheric gliomas surgically treated (biopsied patients excluded) between 1978 and 1989 were retrospectively reviewed. Thalamic, basal ganglia, callosal, or ventricular location were not considered. All tumours were World Health Organisation (WHO) grade II gliomas: 42 fibrillary and 11 gemistocytic astrocytomas, 49 oligodendrogliomas, and 29 oligoastrocytomas. Patients' ages ranged from 14 to 63 (mean 32.9, median 34) years, Karnofsky performance from 0.50 to 0.90 (mean 80.7, median 80), and postsurgical follow up of the living patients from 24 to 190 (mean 97.02, median 93) months. Postoperative external radiotherapy was performed in 49 cases. RESULTS: The overall survival probability at five years was 97.1%, at eight years 76.1%, and at 10 years 62.7% (median survival time 144 months). The impact on survival of the following variables was analysed: age (< 20, 21-40, and > 40 years), Karnofsky score (80-100, 70 < or = 70), histology, tumour extension (T1 < 3 cm, T2 3-5 cm, T3 > 5 cm maximum diameter), extent of surgical resection (S1 radical, S2 subtotal < 10% residual tumour, S3 partial-10%-50% residual tumour), and radiotherapy (either performed or not). A significant positive association with survival at univariate analysis was found for the age group < 20 years (P = 0.003), for total and subtotal surgical resections (S1 and S2; P < 0.001) and for the non-irradiated patients (P = 0.0049), whereas a shorter survival probability was noticed for gemistocytic astrocytomas (P < 0.001) and for tumour extension > 5 cm (T3; P = 0.0193). Karnofsky performance did not show any significant association with survival. The most relevant factor affecting survival at the multivariate analysis was the extent of surgical resection, which resulted as the only variable retaining a significant value (P = 0.001, risk factor = 2.20). CONCLUSIONS: The data strongly support the role of a surgical removal as extensive as possible in the treatment of these tumours.
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- 1996
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169. Enzymatic activities affecting exogenous nicotinamide adenine dinucleotide in human skin fibroblasts
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G. Pompucci, Augusto Preti, Silvia Sestini, and Maria Francesca Aleo
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chemistry.chemical_classification ,Purine ,Nicotinamide ,Physiology ,Chemistry ,Clinical Biochemistry ,Cell Biology ,Nicotinamide adenine dinucleotide ,Molecular biology ,chemistry.chemical_compound ,Enzyme ,Biochemistry ,Extracellular ,NAD+ kinase ,Hypoxanthine ,Nicotinamide mononucleotide - Abstract
The fate of nicotinamide adenine dinucleotide (NAD), AMP, and ADP-ribose supplied to intact human skin fibroblasts was monitored, and the concentrations of intra- and extracellular pyridine and purine compounds were determined by HPLC analysis. Two enzymatic activities affecting extracellular NAD were detected on the plasma membrane, one hydrolyzing the pyrophosphoric bond and yielding nicotinamide mononucleotide (nucleotide pyrophosphatase) and the other cleaving the glycoside link and releasing nicotinamide (NAD-glycohydrolase). No AMP or ADP-ribose was found in the extracellular medium of cells incubated with NAD, the former being completely catabolized to hypoxanthine and the latter degraded to adenine and hypoxanthine.
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- 1996
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170. The impact of repeated surgery and adjuvant therapy on survival for patients with recurrent glioblastoma
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Mario Balducci, Angelo Pompucci, Gina Lama, Alba Fiorentino, Carmelo Anile, Silvia Chiesa, Giulio Maira, Annunziato Mangiola, Gigliola Sica, and Pasquale De Bonis
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Male ,Palliative care ,Data Interpretation ,medicine.medical_treatment ,Settore MED/27 - NEUROCHIRURGIA ,Kaplan-Meier Estimate ,Neurosurgical Procedures ,80 and over ,Medicine ,Adjuvant ,Ultrasonography ,Aged, 80 and over ,Univariate analysis ,Brain Neoplasms ,Palliative Care ,General Medicine ,Chemoradiotherapy ,Statistical ,Middle Aged ,Combined Modality Therapy ,Magnetic Resonance Imaging ,Local ,Data Interpretation, Statistical ,Regression Analysis ,Female ,Adjuvant therapy ,Glioblastoma ,Outcome ,Recurrent glioblastoma ,Surgery ,medicine.drug ,Adult ,Reoperation ,medicine.medical_specialty ,recurrence ,Subgroup analysis ,NO ,Confidence Intervals ,Humans ,Survival analysis ,Aged ,Temozolomide ,business.industry ,Chemoradiotherapy, Adjuvant ,Survival Analysis ,Neoplasm Recurrence ,Neurology (clinical) ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Treatment of glioblastoma recurrence can have a palliative aim, after considering risks and potential benefits. The aim of this study is to verify the impact of surgery and of palliative adjuvant treatments on survival after recurrence.From January 2002 to June 2008, we treated 76 consecutive patients with recurrent glioblastoma. Treatment was: 1-surgery alone--17 patients; 2-adjuvant-therapy alone--24 patients; 3-surgery and adjuvant therapy--16 patients; no treatment--19 patients. The impact on median overall-survival (OS-time between recurrence and death/last follow-up) of age, Karnofsky performance scale (KPS), resection extent and adjuvant treatment scheme (Temozolomide alone vs low-dose fractionated radiotherapy vs others) was determined. Survival curves were obtained through the Kaplan-Meier method. Cox proportional-hazards was used for multivariate analyses. Significance was set at p0.05.Median OS was 7 months. At univariate analysis, patients with a KPS≥70 had a longer OS (9 months vs 5 months--p0.0001). OS was 6 months for patients treated with surgery alone, 5 months for patients that received no treatment, 8 months for patients treated with chemotherapy alone, 14 months for patients treated with surgery and adjuvant therapy--p=0.01. Patients with a KPS70 were significantly at risk for death - HR 2.8 - p=0.001. Subgroup analysis showed no significant differences between patients receiving gross total or partial tumor resection and among patients receiving different adjuvant therapy schemes. Major surgical morbidity at tumor recurrence occurred in 16 out of 33 patients (48%).It is fundamental, before deciding to operate patients for recurrence, to carefully consider the impact of surgical morbidity on outcome.
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- 2013
171. Radioimmunotherapy for high-grade glioma
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Annunziato Mangiola, Vera Vigo, Carmelo Anile, Giorgio Lofrese, Pasquale De Bonis, and Angelo Pompucci
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Oncology ,medicine.medical_specialty ,Poor prognosis ,medicine.drug_class ,medicine.medical_treatment ,Immunology ,Population ,Settore MED/27 - NEUROCHIRURGIA ,Monoclonal antibody ,Treatment failure ,Antibodies ,NO ,Glioma ,Internal medicine ,Monoclonal ,medicine ,Immunology and Allergy ,Animals ,Humans ,Molecular Targeted Therapy ,education ,High-Grade Glioma ,Radioisotopes ,education.field_of_study ,business.industry ,Antibodies, Monoclonal ,Radioimmunotherapy ,medicine.disease ,business ,Glioblastoma - Abstract
Patients with high-grade glioma (HGG) still have a very poor prognosis. The infiltrative nature of the tumor and the inter- and intra-tumoral cellular and genetic heterogeneity, leading to the acquisition of new mutations over time, represent the main causes of treatment failure. Radioimmunotherapy represents an emerging approach for the treatment of HGG. Radioimmunotherapy utilizes a molecular vehicle (monoclonal antibodies) to deliver a radionuclide (the drug) to a selected cell population target. This review will provide an overview of preclinical and clinical studies to date and assess the effectiveness of radioimmunotherapy, focusing on possible future therapies for the treatment of HGG.
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- 2013
172. CSF dynamics analysis in patients with post-traumatic ventriculomegaly
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Annunziato Mangiola, Carmelo Anile, Pierpaolo Mattogno, Rita Formisano, Angelo Pompucci, and Pasquale De Bonis
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Ventriculostomy ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Settore MED/27 - NEUROCHIRURGIA ,Sensitivity and Specificity ,Ventriculoperitoneal Shunt ,NO ,Cerebrospinal Fluid Pressure ,medicine ,80 and over ,Humans ,In patient ,Neurorehabilitation ,Aged ,Third Ventricle ,Aged, 80 and over ,Brain Injuries ,Female ,Hydrocephalus ,Middle Aged ,Prognosis ,Treatment Outcome ,Third ventricle ,business.industry ,General Medicine ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Neurology (clinical) ,Cerebrospinal fluid pressure ,Radiology ,business ,Shunt (electrical) ,Ventriculomegaly - Abstract
Objective The management of post-traumatic ventriculomegaly (PTV) is controversial. This is due to the difficulty to determine whether PTV is related to an atrophic process or to a true “active” hydrocephalus. The purpose of this study is to analyze the CSF-dynamics in patients with PTV and, possibly, to identify parameters that correlate with prognosis. Methods 15 patients with PTV were treated following this protocol: 1-frontal ventriculostomy (with Rickham reservoir); 2-CSF-dynamics evaluation; 3-ventriculo-peritoneal shunt. CSF dynamics evaluation was based on an intraventricular infusion test (performed three to five days after ventriculostomy). Outflow Resistance (R-out) and Intracranial Elastance Index (EI, i.e. the reciprocal of intracranial compliance) were calculated. Patients were classified according to response to shunt into: 1-fast responders: rapid clinical improvement, i.e. within days/one month from surgery; 2-slow responders: patients presenting little clinical improvement occurring after months (despite neurorehabilitation); 3-non responders: no clinical improvement. Results Seven patients (46.7%) were classified as fast-responders, three patients were classified as slow-responders (20%) and five patients were classified as non-responders (33.3%). Opening CSF pressure was less than 15 mmHg for all patients. R-out (cut-off >10 mmHg/ml/min) had 100% sensitivity, 50% specificity, 100% negative predictive value and 63.6% positive predictive value. EI (cut-off value >0.3) had 100% specificity, 42.4% sensitivity, 100% positive predictive value and 66.7% negative predictive value. Conclusions Based on these considerations, we can suggest that, for patients with normal pressure PTV, analysis of CSF dynamics could be of help in selecting patients for CSF-shunt. A combination of Intracranial Elastance and of R-out could help predicting shunt responsiveness.
- Published
- 2013
173. Callosotomy for drug resistant generalized seizures
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Rossi, Gabriella, Colicchio, Gabriella, Marchese, Enrico, Pompucci, Angelo, Marchese, Enrico (ORCID:0000-0001-8551-0357), Pompucci, Angelo (ORCID:0000-0002-5427-9719), Rossi, Gabriella, Colicchio, Gabriella, Marchese, Enrico, Pompucci, Angelo, Marchese, Enrico (ORCID:0000-0001-8551-0357), and Pompucci, Angelo (ORCID:0000-0002-5427-9719)
- Abstract
We report our series of drug resistant epileptic patients submitted to callosotomy. The 25 patients were affected by severe epilepsy with invalidating generalized seizures with fall, lacking of indication for ablative surgery. Nineteen patients, with at least 1 year of follow-up, were considered for this study. The surgical outcome was classified as: class A), seizure disappearance; class B) 80%, class C) 80-50%, class D) less than 50% seizure reduction; E) increase of seizure frequency. The follow-up analysis shows that the better results are obtained with the generalized seizures, in particular the GTA. Our surgical results are discussed considering the data of the literature: about the functional anatomy of the Corpus Callosum, the experimental studies and the clinical series published on callosotomized epileptic patients.
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- 1997
174. High-grade glioma: elderly patients, older treatments
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Manuela Porso, Carmelo Anile, Annunziato Mangiola, Angelo Pompucci, and Pasquale De Bonis
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Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,Salvage therapy ,temozolomide ,elderly ,NO ,Glioma ,Internal medicine ,medicine ,Pharmacology (medical) ,radiotherapy ,Chemotherapy ,Temozolomide ,business.industry ,General Neuroscience ,Neurooncology ,glioblastoma ,Cancer ,trial ,medicine.disease ,Surgery ,Radiation therapy ,elderly, glioblastoma, radiotherapy, temozolomide, trial ,Cohort ,Neurology (clinical) ,business ,medicine.drug - Abstract
Patients aged 65 years or older represent half of all patients with glioblastoma. Nonetheless, this older cohort is often excluded from trials. The NOA-08 Phase III trial compared radiotherapy (RT) (60 Gy) versus temozolomide (TMZ; 100 mg/m(2)) in the elderly patients (65 years and older) with high-grade glioma. Median overall survival was comparable between the two groups (8.6-RT- and 9.6-TMZ-months). Resection extent was the only independent prognostic factor for overall survival. Several concerns arise: the inclusion of patients with a very low Karnofsky Performance Status (KPS; KPS = 20), the lack of an analysis of the impact of KPS and comorbidities on outcome, the salvage therapy administered at tumor progression (RT in the TMZ group and TMZ in the RT group), which could have balanced the effects of primary treatments, the absence of information on spread of disease/tumor site, the mixture of grade III and grade IV histologies. Ongoing trials evaluating RT plus TMZ, RT plus bevacizumab and other treatment modalities in the elderly population are going to change clinical practice in the near future.
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- 2012
175. Decompressive craniectomy, interhemispheric hygroma and hydrocephalus: a timeline of events?
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Simona Gaudino, Angelo Pompucci, Carmelo Anile, Carmelo Lucio Sturiale, Annunziato Mangiola, Luigi Rigante, Cesare Colosimo, Matia Martucci, and Pasquale De Bonis
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Male ,HC ,medicine.medical_treatment ,Settore MED/27 - NEUROCHIRURGIA ,DC ,Cerebrospinal fluid ,Traumatic brain injury ,Central Nervous System Infections ,TBI ,80 and over ,Tomography ,Intracranial pressure ,Aged, 80 and over ,subdural hygroma ,Brain Neoplasms ,Age Factors ,General Medicine ,Middle Aged ,X-Ray Computed ,Subdural hygroma ,head trauma ,Decompressive craniectomy ,Female ,Lymphangioma, Cystic ,CSF ,GCS ,Glasgow Coma Scale ,Hydrocephalus ,ICP ,Interhemispheric hygroma ,SH ,cerebrospinal fluid ,decompressive craniectomy ,hemorrhagic contusions ,intracranial pressure ,traumatic brain injury ,Adolescent ,Adult ,Aged ,Brain Injuries ,Contusions ,Decompressive Craniectomy ,Humans ,Intracranial Hemorrhages ,Logistic Models ,Retrospective Studies ,Tomography, X-Ray Computed ,Young Adult ,medicine.medical_specialty ,Head trauma ,NO ,Cystic ,craniectomy ,medicine ,Lymphangioma ,business.industry ,medicine.disease ,Surgery ,Neurology (clinical) ,business - Abstract
Background Decompressive craniectomy (DC) is a known risk factor for the development of post-traumatic hydrocephalus. The occurrence of subdural hygroma (SH) was also reported in 23–56% of patients after DC and it seemed to precede hydrocephalus in more than 80% of cases. We analyzed the relationship among DC, SH and hydrocephalus. Methods From 2007 to 2011, 64 patients underwent DC after head trauma. Variables we analyzed were: intaventricular hemorrhage, age, GCS, distance of craniectomy from the midline, evacuation of a hemorrhagic contusion (HC) and infection. Logistic regression was used to assess the independent contribution of the predictive factors to the development of hydrocephalus. Results Nineteen patients (29.7%) developed hydrocephalus. Interhemispheric SH was present in 8/19 patients with hydrocephalus and temporally preceded the occurrence of ventricular enlargement. Moreover, most patients who developed a interhemispheric SH had been undergone DC whose superior margin was close to the midline. Logistic regression analysis showed that craniectomy closer than 25 mm to the midline was the only factor independently associated with the development of hydrocephalus. Conclusion Craniectomy close to the midline can predispose patients to the development of hydrocephalus. SH could be generated with the same mechanism, and these three events could be correlated on a timeline.
- Published
- 2012
176. The fate of a macroporous hydroxyapatite cranioplasty four years after implantation: macroscopical and microscopical findings in a case of recurrent atypical meningioma
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Mariangela Novello, Pier Paolo Mattogno, Angelo Pompucci, Pasquale De Bonis, Carmelo Anile, Annunziato Mangiola, Paolo Frassanito, and Domenico Brinchi
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medicine.medical_specialty ,Bioceramic ,Cranioplasty ,Hydroxyapatite ,Osteointegration ,Skull repair ,Biocompatible Materials ,Bone Cements ,Craniotomy ,Durapatite ,Female ,Humans ,Magnetic Resonance Imaging ,Meningioma ,Middle Aged ,Neoplasm Recurrence, Local ,Skull Neoplasms ,medicine.medical_treatment ,Settore MED/27 - NEUROCHIRURGIA ,Dentistry ,Prosthesis ,Osseointegration ,NO ,medicine ,Ossification ,business.industry ,Atypical meningioma ,General Medicine ,medicine.disease ,Surgery ,Neoplasm Recurrence ,Local ,cranioplasty ,Neurology (clinical) ,Implant ,medicine.symptom ,business - Abstract
Reconstruction of calvarial bone defects can be achieved using utologous bone or awide range of prostheticmaterials [1].Macroorous hydroxyapatite (MH) has histologically proven its potential steointegration in animal models [2–4]. Recent radiological and linical data in human subjects are in favour of good osteointegraion of MH cranioplasty [5,6]. However, the MH implant has weak echanic stability and is prone to fractures [7]. Furthermore, it is ot known how fast and to which extent the implant is ossified n vivo. We report a case with limited ossification of a MH prosthesis our years after implantation.
- Published
- 2012
177. Electric fields for the treatment of glioblastoma
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Pasquale De Bonis, Carmelo Anile, Angelo Pompucci, Annunziato Mangiola, and Francesco Doglietto
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Oncology ,medicine.medical_specialty ,Poor prognosis ,medicine.medical_treatment ,Settore MED/27 - NEUROCHIRURGIA ,Malignant Cerebral Tumor ,tumor-treating fields ,chemotherapy ,electric fields ,NO ,Quality of life ,Internal medicine ,medicine ,In patient ,glioblastoma ,recurrent glioblastoma ,treatment ,trial ,Neurology (clinical) ,Neuroscience (all) ,Pharmacology (medical) ,Chemotherapy ,business.industry ,General Neuroscience ,Recurrent glioblastoma ,chemotherapy, electric fields, glioblastoma, recurrent glioblastoma, treatment, trial, tumor-treating fields ,Cancer ,medicine.disease ,Surgery ,business ,Glioblastoma - Abstract
Evaluation of: Stupp R, Wong ET, Kanner AA et al. NovoTTF-100A versus physician’s choice chemotherapy in recurrent glioblastoma: a randomised Phase III trial of a novel treatment modality. Eur. J. Cancer 48(14), 2192–2202 (2012).Glioblastoma (GBM) is the most common primary malignant cerebral tumor in adults, with a poor prognosis despite several therapeutic efforts. Electric fields (EFs) have shown promising results as a new anticancer treatment. Stupp et al. report on the first Phase III trial comparing EF versus chemotherapy in patients with recurrent GBM. The study was designed for superiority; although well conducted, it might not have shown it for a limited compliance in the EF group. Even with this limitation, the trial has shown at least equivalence of EF to chemotherapy, with a decreased toxicity and increased quality of life favoring EF. Further basic and clinical studies are warranted to increase knowledge, efficacy, compliance and cost–effectiveness. This trial has opened a new promising field...
- Published
- 2012
178. 'Blinding' Empty Sella Can Lumbar Puncture Be Avoided?
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Carmela Grazia Caputo, Annunziato Mangiola, Angelo Pompucci, Paolo Frassanito, Carmelo Anile, Pasquale De Bonis, Gianluca Trevisi, and Carlotta Ginevra Nucci
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medicine.medical_specialty ,Blinding ,Settore MED/27 - NEUROCHIRURGIA ,Vision Disorders ,Spinal Puncture ,NO ,Arts and Humanities (miscellaneous) ,medicine ,Humans ,Tomography ,medicine.diagnostic_test ,Lumbar puncture ,business.industry ,Ophthalmoscopes ,Empty Sella Syndrome ,Headache ,Middle Aged ,Magnetic Resonance Imaging ,Surgery ,empty sella ,Optical Coherence ,Female ,Tomography, Optical Coherence ,Neurology (clinical) ,business - Published
- 2012
179. Mild and Moderate Pediatric Head Trauma in Italy: a National Survey
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Cavallo, Selene Marika, Serpico, Fabio, Rossi, Davide, Valluzzi, Adelaide, Ghadirpour, Reza, Spacca, Barbara, Lippa, Laura, Pompucci, Angelo, Giordano, Flavio, Iaccarino, Corrado, and Pavesi, Giacomo
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- 2024
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180. An HPLC-linked assay of phosphoribosylpyrophosphate synthetase activity in the erythrocytes of adults and children with neurological disorders
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Marina Rocchigiani, G. Pompucci, and Vanna Micheli
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Adult ,Male ,medicine.medical_specialty ,Erythrocytes ,Adolescent ,Clinical Biochemistry ,Rett syndrome ,Biochemistry ,High-performance liquid chromatography ,chemistry.chemical_compound ,Intellectual Disability ,Orotidine ,Internal medicine ,Rett Syndrome ,Ribose-Phosphate Pyrophosphokinase ,medicine ,Uridine monophosphate ,Humans ,Autistic Disorder ,Child ,Chromatography, High Pressure Liquid ,chemistry.chemical_classification ,biology ,Biochemistry (medical) ,Infant ,General Medicine ,Middle Aged ,medicine.disease ,Enzyme assay ,Developmental disorder ,Red blood cell ,medicine.anatomical_structure ,Endocrinology ,Enzyme ,chemistry ,Child, Preschool ,biology.protein ,Female ,Nervous System Diseases - Abstract
A two-step non-radioactive method that uses reverse-phase high-performance liquid chromatography (RP-HPLC) is described for the determination of phosphoribosylpyrophosphate synthetase (EC 2.7.6.1) activity in human erythrocytes. The method is accurate and easily reproducible in different chromatographic systems; it is based on the quantification of phosphoribosylpyrophosphate by conversion into orotidine monophosphate and uridine monophosphate. Phosphoribosylpyrophosphate synthetase activity was determined in the erythrocytes of healthy adults and children, the latter showing significantly higher activity than the former. The enzyme activity assayed in children with different neurological disorders was significantly lower in patients with Rett syndrome than in control children or in autistic or mentally retarded patients.
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- 1994
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181. Callosotomy for severe epilepsies with generalized seizures: outcome and prognostic factors.
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Rossi, Gianfranco, Colicchio, Gabriella, Marchese, Enrico, Pompucci, Angelo, Marchese, Enrico (ORCID:0000-0001-8551-0357), Pompucci, Angelo (ORCID:0000-0002-5427-9719), Rossi, Gianfranco, Colicchio, Gabriella, Marchese, Enrico, Pompucci, Angelo, Marchese, Enrico (ORCID:0000-0001-8551-0357), and Pompucci, Angelo (ORCID:0000-0002-5427-9719)
- Abstract
The purpose of the present study was to verify the effect of callosotomy on generalized seizures, to check the effect on other seizure types and to search for possible prognostic factors. Twenty patients with a minimum follow-up of one year (mean 3.5 years) were available for our analysis. In six of them the callosotomy was performed in two stages (total: 26 surgical procedures). Age ranged from 14 to 40 years (mean 23 years). Different aetiologies were known in 15 patients. Duration of epilepsy ranged from 6 to 23 years (mean 15 years). The frequency of seizures ranged between 19 and 750 per month. The most significant effect of surgery was the complete suppression of the generalized seizures associated with falling in 9/19 and their reduction of more than 80% in 7/19 patients (total "good results": 16/19). The generalized tonic-clonic seizures were less affected. The surgical effect on the partial seizures was very variable, the partial simple seizures being the most affected. A positive statistical association with the outcome of the generalized seizures with fall was found for a presurgical seizure frequency below 90 per month, a prevalent bilateral EEG epileptic activity and, to a less extent, the absence of cerebral structural lesions. The role of age, aetiology, duration of the disease, single or more seizure types, mental impairment and extent of callosotomy remains uncertain. Disconnection syndrome does not appear if the splenium is spared. The present findings confirm that the main indication for callosotomy is the occurrence of generalized seizures with fall. Surgery can be initially limited to the anterior 2/3 of the corpus callosum; further posterior section of the corpus, excluding the splenium, should be regarded as a second step, when necessary.
- Published
- 1996
182. Cerebral metabolic rate for glucose of NPH patients increases in shunt-reponders
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A, Mangiola, M L, Calcagni, P, De Bonis, L, Rigante, A, Pompucci, M D, La Valle, L, Indovina, A, Giordano, and C, Anile
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Male ,Glucose ,Humans ,Female ,Hydrocephalus, Normal Pressure ,Research Article - Abstract
The regional cerebral metabolic rate for glucose (rCMRglu) has never been investigated in large consecutive groups of patients with normal pressure hydrocephalus (NPH), a potentially treatable form of dementia with an unpredictable outcome after shunt surgery. Using PET and 18F-2-fluorodeoxyglucose, rCMRglu was studied in 18 patients who fulfilled hydrodynamic criteria for NPH and in whom a biopsy of the frontal cortex was obtained. When compared with an age matched group of 11 healthy subjects, the patients with NPH showed a significant rCMRglu reduction in all cortical and subcortical regions of interest. Individual metabolic patterns, however, disclosed a large topographical heterogeneity. Furthermore, histopathological examination identified Alzheimer's disease or cerebrovascular disease in six cases, and no parenchymal disease or non-specific degenerative processes in the remaining 12. After separating the patients according to the histological diagnosis, the rCMRglu patterns were still heterogeneous, the abnormalities ranging from focal to diffuse in both subgroups. After shunt operation, 11 patients did not improve or worsened clinically. Six patients improved; of those, two had Alzheimer changes and two cerebrovascular changes in their biopsy. The metabolic pattern of these six patients did not differ from the rest of the NPH group. The results indicate that the NPH syndrome may be non-specifically associated with different degenerative disorders. The metabolic heterogeneity, together with the heterogeneous histopathological findings, indicate the necessity of reevaluating the pathogenesis of the NPH syndrome, and may account for the high variability in the success rate of shunt surgery series.
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- 2011
183. Cranial repair: how complicated is filling a 'hole'?
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Pasquale De Bonis, Carmelo Anile, Paolo Frassanito, Carlotta Ginevra Nucci, Annunziato Mangiola, and Angelo Pompucci
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,NO ,Young Adult ,Postoperative Complications ,medicine ,80 and over ,Humans ,Complication rate ,Reconstructive Surgical Procedures ,Craniotomy ,Epidural Hemorrhage ,Aged ,Aged, 80 and over ,business.industry ,Wound dehiscence ,Skull ,Female ,Middle Aged ,Plastic Surgery Procedures ,medicine.disease ,Cranioplasty ,Surgery ,medicine.anatomical_structure ,Decompressive craniectomy ,Neurology (clinical) ,business - Abstract
In general, cranioplasty is viewed as a straightforward surgical procedure, and for many years the complications associated with the procedure have been underestimated. We reviewed our 5-year experience consisting of 218 cranioplasties. Study outcomes focused specifically on the occurrence of complications after cranioplasty. Autologous bone-assisted and prosthetic cranioplasties were considered. Variables described by other authors to be associated with complications were studied, including history of previous cranioplasty, wider craniectomy size, bifrontal craniectomy, and delayed cranioplasty. We also analyzed the influence of material used for craniectomy on the occurrence of complications. The overall complication rate was 19.7%. Nineteen cases of infection (8.7%), 5 cases of postoperative wound dehiscence (2.3%), 6 cases of epidural hemorrhage (2.8%), and 13 cases of cranioplasty dislocation (5.9%) were observed. Bifrontal cranioplasties were more frequently associated with complications (p=0.01; Fisher's exact test) and infection (p0.0001; Fisher's exact test). Postoperative wound dehiscence was more frequently observed with hand-made or custom-made cranioplasties compared with autologous cranioplasties (p=0.02). Early cranioplasty (3 months from craniectomy) was significantly associated with cranioplasty dislocation (p=0.03). Logistical regression analysis showed that the only factor independently associated with complication was the site of cranioplasty (p=0.01). In particular, patients with a bifrontal cranioplasty had a 2-fold increased risk of complication (CI 95 1.1-3.6, p=0.017) and a 2.5-fold increased risk of developing infection (CI 95 1.3-4.9, p=0.009) compared with hemispheric/bihemispheric cranioplasty. Our analysis confirms that cranioplasty is burdened by a significant complication rate. In this context, bifrontal cranioplasty is related to a higher risk of complication and, in particular, infection.
- Published
- 2011
184. Cauda Equina Enhancing Lesion in an HIV-Infected Patient. Case Report and Literature Review
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DE BONIS, Pasquale, Cingolani, Antonella, Pompucci, Angelo, Tartaglione, Tommaso, Larocca, Luigi M, and Teofili, Luciana
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hemic and lymphatic diseases ,virus diseases ,Case Reports ,Settore MED/17 - MALATTIE INFETTIVE ,NO ,toxoplasmosis ,aids ,Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA - Abstract
We report the case of an HIV-infected young men with neuro-toxoplasmosis localized in the spinal cord. The patient received chemotherapy and immunotherapy for Burkitt lymphoma one year before. At the time of the diagnosis of toxoplasmosis, he was on prophylaxis with trimethoprim and sulfamethoxazole and in complete remission of Burkitt lymphoma. The CD4+ T cell count was 270/μl and the HIV viremia was undetectable. These findings suggest that in this patient, the immunodeficiency promoting the neurologic toxoplasmosis arose more from previous immuno-chemotherapy than from the HIV-infection itself. On the whole, this case highlights that the risk stratification for opportunistic infections of HIV-infected patients should carefully consider their previous medical history and therapies received.
- Published
- 2011
185. Whole-brain radiotherapy combined with surgery or stereotactic radiotherapy in patients with brain oligometastases: long-term analysis
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Mario Balducci, Maria Carmen De Santis, Vincenzo Valentini, Silvia Chiesa, Giuseppe Maria Di Lella, Giuseppe D'Agostino, Rosa Autorino, Nicola Dinapoli, Giovanna Mantini, Alba Fiorentino, Luigi Azario, Angelo Pompucci, Alessio Albanese, Vincenzo Frascino, Carmelo Anile, and Stefania Manfrida
- Subjects
Male ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Recursive partitioning ,Breast Neoplasms ,Kaplan-Meier Estimate ,Radiosurgery ,Group B ,Stereotactic radiotherapy ,Cohort Studies ,surgery ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,radiotherapy ,Retrospective Studies ,Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA ,Performance status ,business.industry ,Brain Neoplasms ,Rectal Neoplasms ,Radiotherapy Planning, Computer-Assisted ,Whole brain radiotherapy ,Significant difference ,Middle Aged ,Combined Modality Therapy ,Surgery ,Radiation therapy ,Oncology ,Female ,Cranial Irradiation ,business - Abstract
To verify whether the treatment of brain oligometastases with whole-brain radiotherapy (WBRT) plus stereotactic radiotherapy (SRT) or surgical resection results in different outcomes. Files of patients affected by brain metastases submitted to surgical resection followed by WBRT (group A) or WBRT + SRT (group B) were retrospectively selected for this study. The two treatment groups were matched for the following potential prognostic factors: WBRT schedule, age, gender, performance status, tumor type, number of brain metastases, extra-cerebral metastases, and recursive partitioning analysis class (RPA). The outcomes of patients in both groups were evaluated in terms of toxicity, local control, and overall survival. Total of 97 patients were selected (56 male; 42 female) who were respectively submitted to surgical resection followed by WBRT (group A, n = 50 patients) or WBRT + SRT (Group B, n = 47 patients). Median follow-up was 95 months (range, 8–171 months). The 1-year local control rates were 46.0% and 69.0% respectively. No significant difference in local tumor control was observed between group A and B (p = 0.10). Median overall survival was 15 and 19 months in group A and B, respectively. One-year survival was 56.0% and 62%, respectively. No difference was observed in the two groups (p = 0.40). Surgery remains the main therapeutic approach in symptomatic patients; nevertheless, our data support the use of WBRT plus SRT in one or two brain metastases smaller than 3 cm.
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- 2011
186. Postoperative infection may influence survival in patients with glioblastoma: simply a myth?
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Libero Lauriola, Pasquale De Bonis, Giorgio Lofrese, Carmelo Anile, Angelo Pompucci, Benedetta Ludovica Pettorini, Mario Balducci, Chiara De Waure, Giulio Maira, Annunziato Mangiola, Alessio Albanese, and Alba Fiorentino
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Adult ,Male ,medicine.medical_specialty ,Settore MED/27 - NEUROCHIRURGIA ,Kaplan-Meier Estimate ,Aged ,Bacterial Infections ,Brain Neoplasms ,Female ,Glioma ,Humans ,Middle Aged ,Postoperative Complications ,Proportional Hazards Models ,Retrospective Studies ,NO ,Internal medicine ,medicine ,Postoperative infection ,In patient ,Proportional hazards model ,business.industry ,Hazard ratio ,Retrospective cohort study ,medicine.disease ,Confidence interval ,Surgery ,Neurology (clinical) ,business ,Glioblastoma - Abstract
Background It is a prevalent myth that a postoperative infection may actually confer a survival advantage in patients with malignant glioma. This contention is based largely on anecdotal reports. Recently, a single-center study showed there was no survival advantage in those patients who had glioblastoma with postoperative infection. Objective To examine the impact of postoperative infections on outcome in patients with glioblastoma treated at our center. Methods This study included 197 patients with newly diagnosed primary glioblastoma treated from January 2001 to January 2008. Of the 197 patients, 10 (5.08%) had postoperative bacterial infection. The Kaplan-Meier method, log-rank test, and Breslow test were used in the univariate approach; Cox regression was used in the multivariable approach. Results The median survival was 16 months (95% confidence interval [CI], 14-18 mo). The infection group had a significant advantage in the median survival: 30 months (95% CI, 21-39) vs 15 months (95% CI, 13-17) for patients without postoperative infection. This advantage was also confirmed by Cox regression; in fact, patients not developing a postoperative infection showed an adjusted hazard ratio for death of 2.3 (95% CI, 1-5.3). Conclusion The association between infection and prolonged survival is not definitive; we acknowledge the considerable difficulties in undertaking this type of study in a retrospective manner. Our results can instead stimulate further multicentric studies (to increase the number of patients) or experimental studies using genetically modified bacteria for treatment of glioblastoma.
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- 2011
187. Decompressive craniectomy for elderly patients with traumatic brain injury: it's probably not worth the while
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Carmelo Anile, Massimo Antonelli, Riccardo Maviglia, Carlotta Ginevra Nucci, Rossano Festa, Annunziato Mangiola, Giovanna Paternoster, Pasquale De Bonis, and Angelo Pompucci
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Decompression ,medicine.medical_specialty ,Data Interpretation ,Traumatic brain injury ,medicine.medical_treatment ,Settore MED/27 - NEUROCHIRURGIA ,Glasgow Outcome Scale ,NO ,law.invention ,Injury Severity Score ,law ,Predictive Value of Tests ,Surgical ,80 and over ,Medicine ,Humans ,Glasgow Coma Scale ,Simplified Acute Physiology Score ,Craniotomy ,Aged ,Aged, 80 and over ,business.industry ,Patient Selection ,Brain ,Brain Injuries ,Data Interpretation, Statistical ,Follow-Up Studies ,Intracranial Hypertension ,Logistic Models ,Patient Discharge ,Prognosis ,Survival Analysis ,Treatment Outcome ,Decompression, Surgical ,Statistical ,medicine.disease ,Intensive care unit ,Surgery ,Decompressive craniectomy ,Neurology (clinical) ,business - Abstract
Decompressive craniectomy (DC) has been regarded as an ultima ratio measure in the treatment of refractory intracranial hypertension after brain injury. Most discussion about its benefits is based on studies performed in patients who are65 years of age. The aim of this study was to identify patients aged ≥66 years who underwent DC after traumatic brain injury (TBI), in order to assess patient outcome and to correlate the values of potential predictors of survival on prognosis. From January 2002 to December 2009, 44 patients aged ≥66 underwent DC (follow-up, 12-102 months). Potential predictors of outcome were analyzed, including age, post-resuscitation Glasgow Coma Scale (GCS) score, presence of mass lesion, Simplified Acute Physiology Score (SAPS) II, Injury Severity Score (ISS), and timing of surgical decompression. Mortality was 48% at discharge from the intensive care unit (ICU), 57% at hospital discharge, and 77% at 1-year follow-up and at last follow-up. A bad outcome Glasgow Outcome Scale Dead-Vegetative State-Severely Disabled (GOS D-VS-SD) was observed in 36/44 patients both at hospital discharge and at 1-year follow-up. Mean SAPS II was 45.2 for patients who survived and 57.3 for patients who had died (p=0.0022). Patients who survived had a higher mean post-resuscitation GCS score (p=0.02). Logistical regression analysis indicated post-resuscitation GCS score as the only independent predictive factor for outcome. None of the 22 patients with a post-resuscitation GCS score of 3-5 had a good outcome, 2/10 (20%) patients with a post-resuscitation GCS score of 6-8 and 6/12 patients (50%) with a post-resuscitation GCS score ≥9 had a good outcome.
- Published
- 2011
188. Prevalence of mutations in LEP, LEPR, and MC4R genes in individuals with severe obesity
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Paolini, B., primary, Maltese, P.E., additional, Del Ciondolo, I., additional, Tavian, D., additional, Missaglia, S., additional, Ciuoli, C., additional, Zuntini, M., additional, Cecchin, S., additional, Bertelli, M., additional, and Pompucci, G., additional
- Published
- 2016
- Full Text
- View/download PDF
189. HPLC determination of oxidized and reduced pyridine coenzymes in human erythrocytes
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G. Pompucci, Vanna Micheli, H A Simmonds, and M. Bari
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Purine ,Erythrocytes ,Lesch-Nyhan Syndrome ,Clinical Biochemistry ,Dehydrogenase ,Oxidative phosphorylation ,Glycogen Storage Disease Type I ,Biochemistry ,Cofactor ,chemistry.chemical_compound ,Ribose-Phosphate Pyrophosphokinase ,Humans ,Nucleotide ,Purine metabolism ,Chromatography, High Pressure Liquid ,chemistry.chemical_classification ,Chromatography ,biology ,Biochemistry (medical) ,General Medicine ,NAD ,Glycerol-3-phosphate dehydrogenase ,Purine-Nucleoside Phosphorylase ,chemistry ,biology.protein ,NAD+ kinase ,Oxidation-Reduction ,NADP - Abstract
The nucleotide concentrations in acid and alkaline erythrocyte extracts have been measured by RP-HPLC in healthy controls and in patients bearing different inherited disorders, with altered erythrocyte NAD(P) levels. The objective was the simultaneous determination of the nucleotide profile and of the oxidative state of pyridine coenzymes by the most suitable extraction method. Both alkaline and acid extractions were necessary to obtain the complete pattern, due to defective recovery of the oxidized or reduced coenzymes, respectively, during the extraction procedures. Purine nucleotide quantification seemed to be reliable by all methods. High NADP+ levels were confirmed in two glucose-6-phosphate dehydrogenase deficient patients, coupled with raised NAD levels, lowered NADPH/NADP+ ratio and increased NADH/NAD+ ratio. Higher NAD+ and normal or lower NADH/NAD+ ratios were found in two hypoxanthine-phosphoribosyltransferase deficient patients, while a patient with superactive phosphoribosylpyrophosphate synthetase showed a decreased NADH level in addition to the low NAD+ level previously found.
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- 1993
- Full Text
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190. Radiosurgery or Fractionated Stereotactic Radiotherapy plus Whole-brain Radioherapy in Brain Oligometastases: A Long-term Analysis
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Balducci, Mario, Autorino, Rosa, Chiesa, Silvia, Mattiucci, Gian Carlo, Pompucci, A, Azario, Luigi, D'Agostino, Giuseppe Roberto, Ferro, Marica, Fiorentino, Alba, Fersino, Sergio, Mazzarella, Ciro, Colosimo, Cesare, Frascino, Vincenzo, Anile, Carmelo, Valentini, Vincenzo, Balducci, Mario (ORCID:0000-0003-0398-9726), Chiesa, Silvia (ORCID:0000-0003-0168-3459), Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Azario, Luigi (ORCID:0000-0001-8575-8627), Colosimo, Cesare (ORCID:0000-0003-3800-3648), Anile, Carmelo (ORCID:0000-0002-0481-9713), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Balducci, Mario, Autorino, Rosa, Chiesa, Silvia, Mattiucci, Gian Carlo, Pompucci, A, Azario, Luigi, D'Agostino, Giuseppe Roberto, Ferro, Marica, Fiorentino, Alba, Fersino, Sergio, Mazzarella, Ciro, Colosimo, Cesare, Frascino, Vincenzo, Anile, Carmelo, Valentini, Vincenzo, Balducci, Mario (ORCID:0000-0003-0398-9726), Chiesa, Silvia (ORCID:0000-0003-0168-3459), Mattiucci, Gian Carlo (ORCID:0000-0001-6500-0413), Azario, Luigi (ORCID:0000-0001-8575-8627), Colosimo, Cesare (ORCID:0000-0003-3800-3648), Anile, Carmelo (ORCID:0000-0002-0481-9713), and Valentini, Vincenzo (ORCID:0000-0003-4637-6487)
- Abstract
To analyze the outcome of patients with brain oligometastases treated by radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) after whole-brain radiotherapy (WBRT).
- Published
- 2015
191. Atypical presentation of progressive multifocal leukoencephalopathy in a multiple myeloma patient after auto-SCT successfully treated with combination therapy
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Angelo Pompucci, Luana Fianchi, Paola Cattani, Luigi Maria Larocca, Giuseppe Leone, Maria Teresa Voso, Livio Pagano, A. De Luca, and Cesare Colosimo
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medicine.medical_specialty ,Pathology ,Combination therapy ,Progressive Multifocal ,immune system diseases ,Leukoencephalopathy ,hemic and lymphatic diseases ,Immunopathology ,Internal medicine ,medicine ,Humans ,Multiple myeloma ,Transplantation ,Hematology ,Slow virus ,business.industry ,Progressive multifocal leukoencephalopathy ,Hematopoietic Stem Cell Transplantation ,Cancer ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,surgical procedures, operative ,Female ,business ,Multiple Myeloma ,human activities ,Settore MED/15 - Malattie del Sangue ,Leukoencephalopathy, Progressive Multifocal - Abstract
Atypical presentation of progressive multifocal leukoencephalopathy in a multiple myeloma patient after auto-SCT successfully treated with combination therapy
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- 2010
192. Sewing needles in the brain: infanticide attempts or accidental insertion?
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Luca Massimi, Carmelo Lucio Sturiale, Angelo Pompucci, Carmelo Anile, Annunziato Mangiola, and R. Roselli
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medicine.medical_specialty ,Settore MED/27 - NEUROCHIRURGIA ,Infanticide ,Poison control ,Asymptomatic ,Anterior fontanelle ,Chronic subdural haematoma ,Injury prevention ,Medicine ,Humans ,Aged, 80 and over ,Neurologic Examination ,Dry needling ,Incidental Findings ,business.industry ,General surgery ,Infant ,medicine.disease ,Foreign Bodies ,Surgery ,medicine.anatomical_structure ,Needles ,Accidental ,Accidents ,Disease Progression ,Neurology (clinical) ,Foreign body ,medicine.symptom ,business ,Tomography, X-Ray Computed - Abstract
BACKGROUND:: Placing of sewing needles in the brain through the anterior fontanelle was first described in Germany in 1914. Forty cases have been reported in the scientific literature; most of them were identified in Turkey and Iran, with only a few cases in the Far East, North and Eastern Europe, and the United States. The only case observed in Italy was recorded in 1987. In nonmedical literature, this practice was frequently described in Persian novels, and it has been thought that this ritual could have been diffused with the Persian Empire domination over the centuries. OBJECTIVE:: We report on a new Italian case of an 82-year-old woman admitted for progressive right hemiparesis and gait disturbance. METHODS:: Brain computed tomography scan showed a left frontoparietal chronic subdural haematoma and, surprisingly, three 4-cm-long sewing needles inserted through the region of the anterior fontanelle. The patient and her friends and family did not remember any event justifying their presence. RESULTS:: Subdural collection was evacuated by craniotomic approach, and the sewing needles were left in place and followed up. CONCLUSION:: The rare cases of intracranial needling reported in the literature may represent only the tip of the iceberg. The phenomenon is usually reported as an incidental finding in asymptomatic adults, whereas many babies could not have been diagnosed because they died. The therapy remains controversial, although many authors suggest only follow-up for asymptomatic patients. In this article, all the pertinent literature is reviewed and the most important clinical aspects are discussed, along with a historical assessment of the problem. Language: en
- Published
- 2010
193. Intraventricular versus intravenous colistin for the treatment of extensively drug resistantAcinetobacter baumanniimeningitis
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De Bonis, P., primary, Lofrese, G., additional, Scoppettuolo, G., additional, Spanu, T., additional, Cultrera, R., additional, Labonia, M., additional, Cavallo, M. A., additional, Mangiola, A., additional, Anile, C., additional, and Pompucci, A., additional
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- 2015
- Full Text
- View/download PDF
194. Successful treatment of multidrug-resistant Acinetobacter baumannii ventriculitis with intrathecal and intravenous colistin
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Pascale, G., Pompucci, A., riccardo maviglia, Spanu, T., Bello, G., Mangiola, A., and Scoppettuolo, G.
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Acinetobacter baumannii ,Adult ,Male ,acinetobacter ,Brain Neoplasms ,Colistin ,Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA ,Anti-Bacterial Agents ,Cerebral Ventriculitis ,Postoperative Complications ,Ependymoma ,Drug Resistance, Multiple, Bacterial ,VENTRICULITIS ,Injections, Intravenous ,Humans ,Injections, Spinal ,Acinetobacter Infections - Abstract
Acinetobacter baumannii (AB) nosocomial infections, especially those due to multi-drug resistant (MDR) strains, are increasingly detected. We report a case of a 42-year-old male patient affected by low-grade ependymoma who developed AB-MDR post-neurosurgical ventriculitis. Initially, because of in vitro susceptibility, we used a combination of intravenous colistin and tigecycline. This treatment resulted in the improvement of the patient's initial condition. However, soon after, the infection relapsed; tigecycline was stopped and treatment with intrathecal colistin was initiated. Cure was achieved by continuing this treatment for approximately three weeks, without adverse effects.
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- 2010
195. Neurological disorders of purine and pyrimidine metabolism
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G. Pompucci, Vanna Micheli, S. Sestini, Piero Luigi Ipata, Marcella Camici, Maria Grazia Tozzi, and Matteo Bertelli
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Purine ,Central Nervous System ,Male ,Hypoxanthine Phosphoribosyltransferase ,Purine-Pyrimidine Metabolism, Inborn Errors ,Adenosine Deaminase ,Biology ,Deoxyguanosine kinase ,Bioinformatics ,chemistry.chemical_compound ,Mice ,Agammaglobulinemia ,Drug Discovery ,medicine ,Ribose-Phosphate Pyrophosphokinase ,Animals ,Humans ,Nucleotide ,Autistic Disorder ,Purine metabolism ,chemistry.chemical_classification ,Neurons ,Adenylosuccinate Lyase ,General Medicine ,Purine/pyrimidine metabolism ,medicine.disease ,Rats ,Phosphotransferases (Alcohol Group Acceptor) ,Pyrimidines ,chemistry ,Biochemistry ,Purine-Nucleoside Phosphorylase ,Hypoxanthine-guanine phosphoribosyltransferase ,Purines ,Pyrimidine metabolism ,Purine nucleoside phosphorylase deficiency ,Female ,Severe Combined Immunodeficiency ,Nervous System Diseases - Abstract
Purines and pyrimidines, regarded for a long time only as building blocks for nucleic acid synthesis and intermediates in the transfer of metabolic energy, gained increasing attention since genetically determined aberrations in their metabolism were associated clinically with various degrees of mental retardation and/or unexpected and often devastating neurological dysfunction. In most instances the molecular mechanisms underlying neurological symptoms remain undefined. This suggests that nucleotides and nucleosides play fundamental but still unknown roles in the development and function of several organs, in particular central nervous system. Alterations of purine and pyrimidine metabolism affecting brain function are spread along both synthesis (PRPS, ADSL, ATIC, HPRT, UMPS, dGK, TK), and breakdown pathways (5NT, ADA, PNP, GCH, DPD, DHPA, TP, UP), sometimes also involving pyridine metabolism. Explanations for the pathogenesis of disorders may include both cellular and mitochondrial damage: e.g. deficiency of the purine salvage enzymes hypoxanthine-guanine phosphoribosyltransferase and deoxyguanosine kinase are associated to the most severe pathologies, the former due to an unexplained adverse effect exerted on the development and/or differentiation of dopaminergic neurons, the latter due to impairment of mitochondrial functions. This review gathers the presently known inborn errors of purine and pyrimidine metabolism that manifest neurological syndromes, reporting and commenting on the available hypothesis on the possible link between specific enzymatic alterations and brain damage. Such connection is often not obvious, and though investigated for many years, the molecular basis of most dysfunctions of central nervous system associated to purine and pyrimidine metabolism disorders are still unexplained.
- Published
- 2010
196. Post-traumatic hydrocephalus after decompressive craniectomy: an underestimated risk factor
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Pasquale De Bonis, Luigi Rigante, Angelo Pompucci, Annunziato Mangiola, and Carmelo Anile
- Subjects
Accidental Falls ,Accidents, Traffic ,Adolescent ,Adult ,Aged ,Craniotomy ,Decompression, Surgical ,Female ,Glasgow Coma Scale ,Glasgow Outcome Scale ,Head Injuries, Closed ,Humans ,Hydrocephalus ,Intracranial Hypertension ,Intracranial Pressure ,Male ,Middle Aged ,Postoperative Complications ,Regression Analysis ,Retrospective Studies ,Risk Factors ,Tomography, X-Ray Computed ,Young Adult ,medicine.medical_treatment ,Settore MED/27 - NEUROCHIRURGIA ,Head Injuries ,Surgical ,Tomography ,Intracranial pressure ,X-Ray Computed ,Anesthesia ,Decompressive craniectomy ,Decompression ,medicine.medical_specialty ,Traumatic brain injury ,Closed ,NO ,medicine ,Traffic ,business.industry ,medicine.disease ,Surgery ,Accidents ,Closed head injury ,Neurology (clinical) ,business - Abstract
The incidence of post-traumatic hydrocephalus (PTH) has been reported to be 0.7-51.4%, and we have frequently observed the development of PTH in patients undergoing decompressive craniectomy (DC). For this reason we performed a retrospective review of a consecutive series of patients undergoing DC after traumatic brain injury (TBI). From January 2006 to December 2009, 41 patients underwent DC after closed head injury. Study outcomes focused specifically on the development of hydrocephalus after DC. Variables described by other authors to be associated with PTH were studied, including advanced age, the timing of cranioplasty, higher score on the Fisher grading system, low post-resuscitation Glasgow Coma Scale (GCS) score, and cerebrospinal fluid (CSF) infection. We also analyzed the influence of the area of craniotomy and the distance of craniotomy from the midline. Logistic regression was used with hydrocephalus as the primary outcome measure. Of the nine patients who developed hydrocephalus, eight patients (89%) had undergone craniotomy with the superior limit25 mm from the midline. This association was statistically significant (p = 0.01 - Fisher's exact test). Logistic regression analysis showed that the only factor independently associated with the development of hydrocephalus was the distance from the midline. Patients with craniotomy whose superior limit was25 mm from the midline had a markedly increased risk of developing hydrocephalus (OR = 17). Craniectomy with a superior limit too close to the midline can predispose patients undergoing DC to the development of hydrocephalus. We therefore suggest performing wide DCs with the superior limit25 mm from the midline.
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- 2010
197. Nocardia brain abscess mimicking high-grade necrotic tumor on perfusion MRI
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Libero Lauriola, Angelo Pompucci, Rosalinda Calandrelli, Cesare Colosimo, Alessandro Cianfoni, and Pasquale De Bonis
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Aged ,Brain Abscess ,Brain Neoplasms ,Diagnosis, Differential ,Humans ,Magnetic Resonance Imaging ,Male ,Necrosis ,Nocardia Infections ,Parietal Lobe ,Nocardia ,Pathology ,medicine.medical_specialty ,Brain tumor ,NO ,Nocardia abscess ,Physiology (medical) ,Diagnosis ,medicine ,Abscess ,Brain abscess ,Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA ,medicine.diagnostic_test ,biology ,business.industry ,Magnetic resonance imaging ,General Medicine ,biology.organism_classification ,medicine.disease ,Neurology ,Differential ,Surgery ,Neurology (clinical) ,Radiology ,Differential diagnosis ,business ,Perfusion ,Necrotic tumor on perfusion MRI ,Diffusion MRI - Abstract
Differentiating a pyogenic cerebral abscess from a cystic brain tumor can be a challenge when using morphological and functional imaging techniques. Several studies on MRI perfusion-weighted imaging (PWI) have demonstrated that enhancing abscess capsules have lower cerebral blood volume ratios (rCBV) than the enhancing rims of necrotic tumors. We report a 67-year-old male with a Nocardia cerebral abscess showing restricted diffusion in the necrotic center, but high values for rCBV in the enhancing capsule on PWI, therefore mimicking a high-grade necrotic tumor. Differential diagnosis between cerebral abscesses and necrotic tumors is greatly improved by the adjunct of diffusion-weighted imaging (DWI) and PWI to the morphological magnetic resonance findings; yet there is still overlap. That an abscess may show increased rCBV along the capsule, therefore mimicking a hypervascular brain tumor on PWI, should be considered when attempting a radiological diagnosis of a ring-enhancing brain lesion.
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- 2010
198. Glioblastoma therapy: going beyond Hercules Columns
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Annunziato Mangiola, Carmelo Anile, Pasquale De Bonis, Luigi Rigante, Gennaro Capone, and Angelo Pompucci
- Subjects
Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Brain tumor ,Antineoplastic Agents ,Neurosurgical Procedures ,NO ,medicine ,Combined Modality Therapy ,Humans ,Pharmacology (medical) ,Tumor growth ,Brain Neoplasms ,Glioblastoma ,Radiotherapy ,Randomized Controlled Trials as Topic ,Temozolomide ,business.industry ,General Neuroscience ,Immunotherapy ,medicine.disease ,Radiation therapy ,Cancer cell ,Cancer research ,Neurology (clinical) ,business ,medicine.drug - Abstract
Glioblastoma multiforme is the most common primary brain tumor in adults. Median survival from the time of diagnosis is 14 months, with less than 5% of patients surviving 5 years. Despite advances in deciphering the complex biology of these tumors, the overall prognosis has only slightly improved in the past three decades. The clinical failure of many therapeutic approaches can be explained by the following considerations: the location of tumors within the brain presents a special set of challenges, including ability of drugs to cross the BBB; cancer cells have unstable genetic structures, very susceptible to mutations; cancer cells have an amalgam of different genetic defects that respond in different ways to any given treatment agent; and, infiltrating and apparently normal but 'activated' cells are evident in the brain surrounding the main tumor. In this way, the biologic phenomena of the 'normal brain' adjacent to the enhanced tumor could allow us to understand the first steps of cancerogenesis and, consequently, to interfere with the pathways responsible for tumor growth and recurrence.
- Published
- 2010
199. Radiotherapy and concomitant temozolomide during the first and last weeks in high grade gliomas: long-term analysis of a phase II study
- Author
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Vincenzo Valentini, Giuseppe D'Agostino, Angelo Pompucci, Berardino De Bari, Alba Fiorentino, Carmelo Anile, G. Apicella, Gabriella Colicchio, Filippo De Renzi, Giovanna Mantini, Annunziato Mangiola, Numa Cellini, Stefania Manfrida, Mario Balducci, and Vincenzo Frascino
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Dacarbazine ,Settore MED/27 - NEUROCHIRURGIA ,Phases of clinical research ,Gastroenterology ,Disease-Free Survival ,Internal medicine ,Temozolomide ,medicine ,Adjuvant therapy ,Combined Modality Therapy ,Humans ,Longitudinal Studies ,Antineoplastic Agents, Alkylating ,Aged ,business.industry ,Brain Neoplasms ,Middle Aged ,Magnetic Resonance Imaging ,Surgery ,Radiation therapy ,Treatment Outcome ,Neurology ,Oncology ,Concomitant ,Toxicity ,Disease Progression ,Female ,Neurology (clinical) ,Radiotherapy, Conformal ,business ,Glioblastoma ,medicine.drug - Abstract
We tested the efficacy and safety of temozolomide (TMZ) when given concomitantly to radiotherapy only in the first and last weeks of treatment to patients affected by high grade gliomas. Conformal radiotherapy (CTV1: tumor bed + residual tumor if present + 1.5 cm, 5,940 cGy, 180 cGy/day; CTV2: oedema, 3,960 cGy, 180 cGy/day) was associated with TMZ, 75 mg/m(2) x 5 days, the first and last weeks of radiotherapy. Adjuvant chemotherapy with TMZ (150 mg/mq daily x 5 days, q28 on the first cycle, 200 mg/mq daily x 5 days, q28 for the following cycles) was given, after chemoradiation, until disease progression or up to 6 cycles. From October 2000 to December 2003, 29 patients (25 GBL, 86.2%; 4 AA, 13.8%) were enrolled in this study. Twenty-two patients (75.8%) received a median 6 cycles of adjuvant chemotherapy with TMZ (range 1-20). Hematological toxicity was absent during concomitant chemoradiation and mild in adjuvant therapy, while neurological toxicity (seizures) was observed only in one case. At a median follow-up of 66 months (range 3-96), median progression-free survival (PFS) was 8 months, with a 1- and 2-year PFS of 46.7 and 28.7%, respectively; median overall survival (OS) time was 21 months, with a 1- and 2-year OS of 69.2 and 42.3%, respectively. In our experience, TMZ proved to be effective even when given only during the first and the last week of radiotherapy, with lower hematological toxicity.
- Published
- 2010
200. Decompressive craniectomy for the treatment of traumatic brain injury: does an age limit exist?
- Author
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Annunziato Mangiola, Luigi Rigante, Angelo Pompucci, Q. Giorgio D'Alessandris, Carmelo Anile, and Pasquale De Bonis
- Subjects
Decompression ,Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Traumatic brain injury ,medicine.medical_treatment ,Settore MED/27 - NEUROCHIRURGIA ,Decompressive craniectomy ,Age limit ,NO ,Young Adult ,Age ,Surgical ,Medicine ,Humans ,In patient ,Statistical analysis ,Young adult ,Craniotomy ,Outcome ,Age Factors ,Brain Injuries ,Female ,Middle Aged ,Decompression, Surgical ,business.industry ,General Medicine ,Evidence-based medicine ,medicine.disease ,Surgery ,business - Abstract
Object It is generally believed that the outcome of traumatic brain injury is not improved by decompressive craniectomy in patients older than 30–50 years. A literature search was performed to assess the level of evidence with respect to the effect of age on outcome in these cases. Methods References were identified by PubMed searches of journal articles published between 1995 and December 2008. The inclusion criteria were as follows: 1) clinical series including adults; and 2) focus on age as a prognostic factor. Technical notes and laboratory investigations were excluded. Results Fourteen English-language articles were finally selected. In 5 of the 14 studies, the authors performed no statistical analysis. In 6 studies they concluded that age was not significantly related to outcome (with 1 of these studies showing a correlation between age and outcome only after 65 years). Three studies showed a correlation between age and outcome. Conclusions With respect to age and effectiveness of decompressive craniectomy, there are no robust data to establish any degree of core evidence and the referred age thresholds are arbitrary.
- Published
- 2009
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